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Although conscientiousness is the personality factor that predicts better performance in medical school and physician practice, a new UC Davis study has found that extroversion is the only personality type associated with better performance in the Multiple Mini-Interview (MMI) process, an increasingly popular method for interviewing and selecting medical students.

Based on the results, published online in the September issue of the journal Academic Medicine, the authors warn that reliance on MMI -- adopted by medical schools nationwide, including the UC Davis School of Medicine -- could potentially lead to medical school classes dominated by a single personality attribute.

Anthony Jerant

"A range of thoughts and styles is important in any institutional setting," said lead author Anthony Jerant, a professor in the UC Davis Department of Family and Community Medicine. "Having a dominant personality type in medicine is a particular concern, since the field has many specialties and, within each, unique and important roles to fill."

In place of the traditional 45-minute applicant interview, MMI is a fast-paced, timed circuit of approximately 10 stations, each featuring a unique 10-minute exercise designed to assess teamwork, problem-solving and communication abilities. Different evaluators, usually physicians or other health-care professionals, at each station rate the applicants using predetermined criteria. The ratings are forwarded to the Admissions Committee, which considers them along with the rest of each applicant's portfolio.

Jerant said that the "speed dating" format of the MMI process favors extroverts, who can be perceived on brief contact to be better communicators.

"That doesn't necessarily mean they actually are better at communicating with patients or colleagues over the long haul," he said. "Extroversion hasn't been shown to confer advantages in other aspects of medical student performance, and we don't know how it affects clinical performance after medical school."

Pioneered by McMaster University in Ontario, Canada, MMI is considered to have several advantages over the traditional medical school interview. It's believed to favor candidates who have the social and communication skills to navigate the complexities of health care and who can think on their feet and work in teams.

"We adopted the MMI approach to explore a potentially more reliable, multisource assessment of our applicants than the traditional, one-on-one interview format," said Mark Henderson, associate dean for admissions at UC Davis School of Medicine and a co-author of the study. "The results raise important questions that can only be answered with longitudinal follow up of students chosen using this method and further studies. We will continue to refine the MMI as part of our selection process with the goal of selecting a diverse group of qualified students capable of handling the challenges of a medical career while remaining dedicated advocates for their patients."

Mark Henderson

In this UC Davis-funded evaluation, Jerant and his team examined the relationship between the personalities of UC Davis School of Medicine applicants and their MMI scores.

They studied 444 applicants for the 2010-11 school year who participated in the MMI process and voluntarily completed a Big Five Inventory questionnaire, a validated measure assessing agreeableness, conscientiousness, extroversion, neuroticism and openness.

Those with extroversion scores in the top quartile had significantly higher MMI scores than their counterparts. Conscientiousness, long considered the best predictor of success in medical school and physician practice, was not associated with higher scores.

"There is a need for broader, multi-school randomized trials to compare the reliability, predictive validity and personality consequences of the MMI with traditional interview processes," Jerant said. "Such studies would also help clarify whether traditional interviews are also likely to favor particular personality types."

In addition to Jerant and Henderson, study authors were Erin Griffin, Julie Rainwater, Francis Sousa, Klea Bertakis, Joshua Fenton and Peter Franks, all of UC Davis. Their study was funded by the UC Davis School of Medicine Office of the Dean and a UC Davis Department of Family and Community Medicine Research Grant.

The UC Davis School of Medicine is among the nation's leading medical schools, recognized for its research and primary-care programs. The school offers fully accredited master's degree programs in public health and in informatics, and its combined M.D.-Ph.D. program is training the next generation of physician-scientists to conduct high-impact research and translate discoveries into better clinical care. Along with being a recognized leader in medical research, the school is committed to serving underserved communities and advancing rural health. For more information, visit UC Davis School of Medicine at www.medschool.ucdavis.edu.